title: Effect of acetazolamide and gingko biloba on the human pulmonary vascular response to an acute altitude ascent.
abstract: Acetazolamide and gingko biloba are the two most investigated drugs for the prevention of acute mountain sickness (AMS). Evidence suggests that they may also reduce pulmonary artery systolic pressure (PASP). To investigate whether these two drugs for AMS prevention also reduce PASP with rapid airlift ascent to high altitude, a randomized controlled trial was conducted on 28 healthy young men with acetazolamide (125 mg bid), gingko biloba (120 mg bid), or placebo for 3 days prior to airlift ascent (397 m) and for the first 3 days at high altitude (3658 m). PASP, AMS, arterial oxygen saturation (Sao2), mean arterial pressure (MAP), heart rate (HR), forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and peak expiratory flow (PEF) were assessed both at 397 m and 3658 m. HR, PEF, and PASP increased with altitude exposure (p<0.05), and SaO2 decreased (p<0.05). PASP with acetazolamide (mean at 3658 m, 26.2 mm Hg; incremental change, 4.7 mm Hg, 95% CI., 2.6-6.9 mm Hg) was lower than that with ginkgo biloba (mean at 3658 m, 33.7 mm Hg, p=0.001; incremental change, 13.1 mm Hg, 95%CI., 9.6-16.5 mm Hg, p=0.002), and with placebo (mean at 3658 m, 34.7 mm Hg, p<0.001; 14.4 mm Hg, 95% CI., 8.8-20.0 mm Hg, p=0.001). The data show that a low prophylactic dosage of acetazolamide, but not gingko biloba, mitigates the early increase of PASP in a quick ascent profile.
authors.affiliation: Department of Occupational and Environmental Health, the Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Fourth Military Medical University, Xi'an, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Ke
authors.forename: Jiye
authors.initials: J
authors.lastname: Wang
authors.forename: Erik R
authors.initials: ER
authors.lastname: Swenson
authors.forename: Xiangnan
authors.initials: X
authors.lastname: Zhang
authors.forename: Yunlong
authors.initials: Y
authors.lastname: Hu
authors.forename: Yaoming
authors.initials: Y
authors.lastname: Chen
authors.forename: Mingchao
authors.initials: M
authors.lastname: Liu
authors.forename: Wenbin
authors.initials: W
authors.lastname: Zhang
authors.forename: Feng
authors.initials: F
authors.lastname: Zhao
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Shen
authors.forename: Qun
authors.initials: Q
authors.lastname: Yang
authors.forename: Jingyuan
authors.initials: J
authors.lastname: Chen
authors.forename: Wenjing
authors.initials: W
authors.lastname: Luo
mesh_terms: D000086:Acetazolamide / Q000627:therapeutic use*; D000208:Acute Disease; D000293:Adolescent; D000532:Altitude Sickness / Q000517:prevention & control*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D020441:Ginkgo biloba; D006801:Humans; D006976:Hypertension, Pulmonary / Q000517:prevention & control*; D016014:Linear Models; D008297:Male; D008517:Phytotherapy; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D004365:Drugs, Chinese Herbal; C526713:ginaton; D000086:Acetazolamide